In Billing
Jul 2nd, 2018
The only case when time may be used as the overriding factor in determining an evaluation and management (E/M) level is when counseling and/or coordinating care dominates the encounter, which means that the time expended on counseling and/or coordinating care exceeds 50 percent of the total encounter time. This applies to non-time-controlled E/M services that ...
Jun 12th, 2018
The typical path to becoming a medical coder starts with a recently graduated high school student who is detail-oriented, enjoys healthcare and anatomy, and learning about medical records and the physician revenue cycle. But not all medical coders start out that way. Some people pursue a career in medical coding because there is the potential to work ...
In Coding
Jun 6th, 2018
Part 1: Educated coders and providers are crucial to claim success. Delivering quality care, while ensuring effective clinical documentation and compliant medical coding, is an ongoing challenge in a fast-paced emergency department (ED). Over the next two months, we’ll review best practices to optimize coding compliance and reimbursement of ED claims. In part 1 of ...
In Audit
Jun 1st, 2018
If you just got one in the mail, don’t panic. Here’s why you probably received it, and how you should respond to it. The Comprehensive Error Rate Testing (CERT) program, which calculates the Medicare fee-for-service (FFS) program improper payment rate based on stratified random samples of Medicare FFS claims, continuously finds the same five leading causes ...
In Billing
May 25th, 2018
Spondylolisthesis is a perfect example of why ICD-10 requires improved clinical documentation. In ICD-9, Acquired spondylolisthesis was reported with one code, 738.4. In ICD-10, there are 14 codes: M43.00 Spondylolysis, site unspecified M43.04 Spondylolysis, thoracic region M43.05 Spondylolysis, thoracolumbar region M43.06 Spondylolysis, lumbar region M43.07 Spondylolysis, lumbosacral region ...